Provider Demographics
NPI:1790776169
Name:ZAMBUTO, DONNA A (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:A
Last Name:ZAMBUTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 NEW DRIFTWAY
Mailing Address - Street 2:STE 201
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-4530
Mailing Address - Country:US
Mailing Address - Phone:781-545-9225
Mailing Address - Fax:781-545-8560
Practice Address - Street 1:10 NEW DRIFTWAY
Practice Address - Street 2:STE 201
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066
Practice Address - Country:US
Practice Address - Phone:781-545-9225
Practice Address - Fax:781-545-8560
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA58914208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
355286OtherCIGNA
MA3105385Medicaid
MAAZR01142OtherBCBS
456193OtherTUFTS USFHP
058914OtherTUFTS
MA201073OtherHPHC
F53828Medicare UPIN
MAAZR01142OtherBCBS